Our Top 5 In-Office Flags that Signal to Refer Your Patient to Occupational Therapy

By Katie Swinson, MS, OTR/L, LSVT

Regional Quality Assurance Liaison

Our world is getting older. People are generally living longer, though that doesn’t translate to living with fewer health concerns or problems. Payors are pushing for faster results and fewer hospital visits. But how can this be done with such time constraints in place?

FOX occupational therapists are trained to help this high-risk population decrease hospital admissions and improve their overall quality of life. Through a focus on occupations or the daily activities someone completes such as bathing and dressing, FOX occupational therapists help to improve our patients’ strength, balance, safety, hygiene, and overall well-being.

As a busy physician, here are 5 quick and easy signs to look for in order to know when a referral to occupational therapy is needed:

WEAK HANDSHAKE

As you greet your patient when you first walk in the exam room, make sure to pay attention to the strength behind their handshake.

Weak grip strength can indicate larger problems among older adults, including a higher hospital readmission rate over the next decade and an increased mortality rate (Simmonds et al., 2015; Sasaki et al., 2007). Therefore, if you receive a weak handshake, there may be other health factors to consider that are coming into play.

FOX occupational therapists can work with patients to improve their overall strength and reduce mortality and hospital readmission rates.

COMPLAINTS OF LOSING HOBBIES

A simple “How have you been doing?” can elicit complaints from your patients about a loss of ability to perform their favorite hobbies, which may be due to a loss of interest or a loss of strength and/or balance.

An inability to complete these leisure activities puts these older adults at a higher risk of being unable to perform their self-care activities, which impacts their overall health and well-being. These self-care activities are what we need to do every day to survive: bathing, dressing, grooming, etc.  When working with a FOX occupational therapist, this patient could learn techniques to adapt the activity or the environment while gaining strength to maintain social and leisure participation.

UNABLE TO SIT ON THE EXAM TABLE WITHOUT SUPPORT

Many times, older adults with balance and strength deficits have a difficult time maintaining their balance without having back support. If you notice your patient is unable to get on the exam table with ease or is often leaning to one side or the other, this older adult would most likely benefit from occupational therapy.

Other indicators of decreased balance and strength could be:

They need to hold onto walls or furniture to walk in the exam room.

They take an abnormally long time to perform a movement you ask them to do, i.e., taking off a jacket or sitting on the exam table.

The need for more support and/or a slower speed of movement indicates a higher risk of falls and decreased safety in their self-care tasks.

DISHEVELED APPEARANCE

A quick glance over a patient’s initial appearance will determine whether there is a breakdown in their ability to complete self-care tasks independently.

If you notice mismatched buttoning, dirty clothing, an unusual body odor, or just a generally unkempt appearance, this would warrant the intervention of an occupational therapist to improve your patient’s optimal functionality and return them to their usual appearance.

REPETITIVE QUESTIONING OR PHRASES

Oftentimes, patients may seem forgetful or have a difficult time recalling the last time they took a medication or the specifics of a recent ailment. When a patient is being more forgetful, having a harder time recalling information, or repeating more questions, this may indicate a need for occupational therapy.

Difficulty recalling personal information may indicate safety issues when taking medications, attending health appointments, or even basic functions at home like turning the stove off.

FOX occupational therapists can implement compensatory techniques to assist with maintaining a safe and healthy life in these cases.

Occupational therapists can help improve a patient’s overall functioning and quality of life through adaptation, skilled exercise prescription, and use of everyday occupations. We help to put the life back in living, and keeping an eye out for these five signals can ensure your patient receives that opportunity to be at optimal function.